I have moved away from providing insurance coverage in my practice due to the significant increase in administrative and paperwork demands that would have required me to increase my staff-- and fees to patients. Insurance companies can also limit and override clinical decisions and your treatment preferences depending on the terms of your contract.
I provide coded monthly invoices (Superbills) to submit to your insurance provider for fee reimbursement. Fortunately, many PPO policies provide reimbursement for out-of-network services (anywhere from 30-90% depending on the policy).
When considering using your PPO coverage for sessions, please check your insurance coverage carefully by asking your insurance provider the following questions:
- Are mental health insurance benefits included in my insurance policy?
- If I have an 'out of network deductible' 1) how much is it? and 2) has it been met?
- What is the reimbursement rate ($$ amount) per therapy session?
- How many psychotherapy sessions does my health insurance plan cover per year?
- Do I need approval for psychotherapy from my primary care physician?